Monty's thoughts

The blog of Monty Moncrieff
London Friend Chief Executive


5th November 2012: Welcome to the Pleasuredrome?


Hello, and welcome to my first blog post as CEO of London Friend. Some of you may know that I was recently appointed, stepping up from my previous Head of Services role, and taking over from our departing CEO Matthew Halliday. I’d like to wish him all the best in his future endeavours and thank him for his success in modernising the oldest LGB & T charity in the UK.


As I take over, one of the areas we specialise in – supporting LGB & T people experiencing drug and alcohol problems – is facing a set of new challenges. Over the past 3 or 4 years we’ve seen such a remarkable shift in the issues our service users present with, particularly gay and bisexual men. We’ve seen drug use change to focus our priorities on two main substances: methamphetamine and G, neither of which are making great ripples within mainstream treatment services but which have changed the game amongst LGB & T people.


Both are causing difficulties that our communities haven’t really experienced before. Four years ago we had little idea that G could cause dependent use, physical symptoms not unlike addiction to very high levels of alcohol. Some of our clients are dosing every hour to avoid potentially fatal withdrawal. Outside of LGB & T use, methamphetamine is the great drug scare that never really happened, as mainstream services see relatively little evidence of it, but we see gay men using it all weekend long. Many users are using the drugs in highly sexualised contexts, in commercial venues and privately at home as the link between drugs and sex becomes ever more common. We get more referrals from sexual health clinics than we ever have as people check-in to get their symptoms checked out, or require PEP after a weekend-long party.


Party hard doesn’t always equate to party unsafely


Naturally as a treatment service we see some of the most problematic issues, and whilst drugs and alcohol remain a disproportionately problematic concern for LGB & T people on the whole, not everyone is at it by any means, or even at it at levels that cause concern. Party hard doesn’t always equate to party unsafely. However, last week things reached a well-publicised crisis point that should make us all reflect; two more deaths were reported from a London sauna, widely assumed to be drug-related. It’s perhaps lurid to speculate in advance of toxicology reports but whatever role drugs may or may not have played in these tragic events the scenario of collapsing in the (very) early hours is one our service users report seeing (or doing) all too frequently and we know from our work with venues and A&E departments that drug-related casualties are not rare. The fact that even the Daily Mail reported the story in a fairly matter-of-fact way may be indicative of just how normalised such things have become.


Of course, there’s nothing new in LGB & T people seeking pleasure and it’s not something exclusive to our populations, and certainly not something that requires inherent judgement, but the trends we see are worrying and potentially the tip of the iceberg. The arguments about why such problems are emerging, and how we get people to think about their own warning signs, are broader than for this piece, and for the entirety of our communities and our sector to begin to engage with, but we need to raise better awareness of the related health and care needs of LGB & T people otherwise as groups we risk remaining overlooked once more within the health and public health reorganisation. This is something London Friend has started to do in relation to drug use and based upon what we are seeing.


Tomorrow I will be delivering a workshop at Drugscope’s conference, talking about the trends we have seen through Antidote, London Friend’s drug and alcohol support service, and the steps we have taken to address these, such as our pioneering partnership with the NHS Club Drug Clinic. I’ll also be talking about the work we are doing with commissioners of substance misuse services to get LGB & T issues considered strategically in needs assessments and local health and well-being strategies, and how effective, targeted support can be provided through imaginative commissioning. Without engagement with the new trends we’re seeing and thoughts of how to prevent and treat emerging drug-related harms our service users may also be continuing to die unnecessarily.



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